Glasgow Coma Scale in Anticipation of Sepsis and Septic Shock : Review Article

Evaluation of level of consciousness has become essential for anticipation of sepsis and septic shock. Both the Sequential Organ Failure Assessment (SOFA) score and the quick SOFA score utilize the Glasgow Coma Score (GCS) for screening of sepsis. Objectives: the aim of this review is to determine and study the role of Glasgow coma score in anticipation of sepsis and septic shock. Methods: To achieve this aim, we have searched online database, namely PubMed and Cochrane Library for studies and review articles assessing the significance of assessment of Glasgow Coma Scale (GCS) for anticipating sepsis or septic shock. Thirteen appropriately-related studies were selected for review. Results: Disturbed sensorium was found to be a sensitive early indicator for sepsis, thus GCS is used for assessment of both the Sequential Organ Failure Assessment (SOFA) and quick SOFA scores qSOFA scores. Lower GCS scores were associated with high mortality rates. Discussion: Encephalopathy is an early sign of sepsis and septic shock. Glasgow Coma score (GCS) was a good indicator of neurological dysfunction evaluated by the SOFA and qSOFA scores. The use of GCS was also a predictor of mortality in patients with sepsis. Some researchers, however, reported that GCS was not the best tool for measuring brain dysfunction in sepsis. Conclusions: Glasgow coma score can anticipate sepsis and septic shock, and predict the outcome of sepsis.